| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $393.38 | $4,722.42 | $8,031.00 | |
Aetna
| Facility | 52 | $196.69 | $196.69 | $199.20 |
Anthem BCBS
| Facility | $12,098.00 | $12,905.00 | $17,206.00 | |
United
| Facility | $3,275.00 | $6,137.00 | $16,193.00 |